The State Hospital New Legislation for Mentally Disordered

The State Hospital New Legislation for Mentally Disordered Offenders • Major Legislative Developments • Interactions between the Criminal Justice and Mental Health Systems • Specific Legislation Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Major Developments within the Mental Health (Care & Treatment) (Scotland) Act 2003 Principles • Participation • Respect for carers • Informal care • Least restrictive alternative • Maximum benefit • Non discrimination • Respect for diversity • Reciprocity • Child welfare - paramount • Equality Forensic Training L. D. G. Thomson@ed. ac. uk New Definitions Mental Health Tribunal Community Treatment Order Services for Children Services for Post Natal Depression Patient Representation • Advocacy • Named Person • Advance Statements Assessment of Needs Security Level Appeals Urgent detention of acquitted persons 14 th September 2005

The State Hospital Mental Health Legislation: Criminal • • Mental Health (Scotland) Act 1984 Criminal Procedure (Scotland)Act 1995 Crime and Punishment (Scotland) Act 1997 Mental Health (Public Safety and Appeals) (Scotland) Act 1999 • Mental Health (Care and Treatment) (Scotland) Act 2003 Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Criminal Justice and Mental Health Systems Police Pre-Trial Acquittal - Place of Safety Informal treatment Emergency or Short-term Detention Assessment Order) from court or Treatment Order) prison Assessment or Treatment as a condition of bail - Psychiatric Defences Conviction Acquittal on grounds of insanity Psychiatric Options for Disposal Urgent Detention of an Acquitted Person Prison - Transfer for Treatment Direction Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Legislation for MDOs Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Legislation for MDOs Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital REMOVAL TO A PLACE OF SAFETY FROM A PUBLIC PLACE - POLICE Section Purpose Conditions : 297 : Medical Examination : Police officer suspects mental disorder in a person in a public place : In immediate need of care and treatment : In person’s interest or for protection of others Powers : Detention in a place of safety for a medical examination Duration : 24 hours Signatories: Police Officer Revocation : Nil Appeal : Nil Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Conditions for Detaining Mentally Disordered Offenders • Mental Disorder • Treatment likely to alleviate symptoms or prevent deterioration is available • Risk to health, safety or welfare of patient; or safety of others • Making the order is necessary No impaired decision making ability criterion for MDOs Court: all circumstances / alternative means Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Remand to Hospital for Assessment Section Purpose : 52 B-J Assessment Order CP(S) A 1995 : Assessment in hospital prior to trial or sentencing. From court or prison Evidence : Written or oral from one registered doctor Conditions : MD / Risk / Detention in hospital necessary to determine if treatment order criteria met / Assessment could not be undertaken if patient not in hospital / bed available in 7 days Powers : Detention in hospital (Not treatment). Restricted Duration : 28 days (7 day extension) Duties : RMO court report : Social circumstances report Revocation or Variation : RMO applies to court Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Remand to Hospital for Treatment Section Purpose : 52 K-S Treatment Order CP(S) A 1995 : Treatment in hospital pre trial or sentencing. From court or prison. Evidence : Written or oral from two registered doctor (1 approved) Conditions : MD / treatability / risk / bed available in 7 days : Can be applied for directly or after an assessment order Powers : Detention in hospital & treatment (Part 16). Restricted Duration : No time limit Duties : RMO court report Revocation or Variation : RMO applies to court Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Pre-sentence Inquiry into Mental or Physical condition Section Purpose Evidence : 200 CP(S) A 1995 : To remand a convicted person in custody or on bail for assessment of mental or physical condition. Bail, prison or hospital : Written or oral from one registered doctor Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Pre-sentence Inquiry into Mental or Physical condition Conditions Duration Duties : convicted of an offence punishable by imprisonment : needs inquiry into mental or physical condition : suffering from a mental disorder : suitable hospital placement available Overlap with S 52 B-J / K-S : 3 weeks (extension for 3 weeks) : Court report prepared in hospital, community or prison Revocation : Court Hospital Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Interim Compulsion Order Section Purpose Evidence Conditions Powers Duration Duties : 53 CP(S) A 1995 : inpatient assessment : written or oral from 2 doctors (1 approved) : MD / treatability / risk / bed available in 7 days : likely compulsion and restriction orders or hospital direction Not just State Hospital : detention and treatment in hospital (Part 16) : 3 -12 months (12 weekly renewal) : RMO report / MHO – SCR Revocation or Variation: no procedure/write to court Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Compulsion Order Section Purpose Evidence Conditions : 57 A CP(S) A 1995 : treatment in hospital or community (CTO) : written or oral from 2 doctors (1 approved) : MD / treatability / risk / hospital - bed available in 7 days Convicted of an offence punishable by imprisonment Powers : Part 16 treatment, attendance, access, residence requirements Duration : 6 months (+ 6 months annual) Duties : care plan Revocation or Variation : Tribunal Non-compliance : as CTO Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Restriction Order Section Purpose Evidence Powers Duration Duties : 59 CP(S) A 1995 : control of high risk patients : oral evidence of 1 medical practitioner : inpatient compulsion order : offence / antecedents / risk : Detention in hospital : Leave and transfer - Scottish Ministers : Without limit of time : RMO (annual) report : MWC / Scottish Ministers Revocation or Variation : Tribunal Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Restriction Order: review Tribunal Review • RMO • MWC • Scottish Ministers • Patient • Named Person • Automatic – 2 years Forensic Training L. D. G. Thomson@ed. ac. uk Criteria • Mental Disorder • Treatability • Risk • Serious risk to others • Compulsion order necessary • Restriction order necessary - variation of compulsion order • Hospital necessary 14 th September 2005

The State Hospital Tribunal Review: CORO Outcome • Absolute discharge • Conditional discharge - defer? • Compulsion order – vary? • CORO Hearing Appeal – delays order Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Direction Section : 59 A CP(S) A 1995 Purpose : combines hospital detention and prison sentence Evidence : oral or written from 2 doctors (1 approved) : doctors can recommend a hospital direction Conditions : as compulsion order / link between mental disorder, offence +/- risk is weak Powers : detention in hospital or prison Duration : length of prison sentence / civil detention – C. T. O. Duties : RMO (annual) reports : MWC / Scottish Ministers Revocation or Variation : Scottish Ministers & Tribunal : E. D. L. : Parole : Release on life licence Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Tribunal Review: Hospital Direction Criteria • Mental Disorder • Treatability • Risk • Serious risk to others • Hospital direction necessary Forensic Training L. D. G. Thomson@ed. ac. uk Outcome • Transfer to prison • Hospital direction Hearing 14 th September 2005

The State Hospital Standard Procedures Admission • in 7 days • place of safety • powers to convey – police, hospital, other Abscond • custody – hospital • inform court / Scottish Executive • revoke or vary order? Forensic Training L. D. G. Thomson@ed. ac. uk Suspension of detention • certificate by RMO • consent of Scottish Ministers • escort • length • location • time limits (TO, ICO, CORO, HD & TTD) • revocation RMO or Scottish Ministers 14 th September 2005

The State Hospital Probation Order Section Purpose Evidence : 230 CP (S) A 1995 : medical or psychological treatment of a mental condition : oral or written by 1 doctor or a chartered psychologist : mental disorder - needs treatment : CTO or CO not required : patient and CJSW agree Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Probation Order Duration Duties Variation Non compliance Forensic Training L. D. G. Thomson@ed. ac. uk : 6 months 3 years : liaison with CJSW : Social Enquiry Report : agreement of supervising officer : inform court : notification to court 14 th September 2005

The State Hospital Intervention and Guardianship Orders Sections Purpose Evidence Conditions : S. 60 B CP(S) A 1995 : S. 58 (1 A) CP (S) A 1995 : personal welfare decisions or management (not financial) : 2 medical reports ( 1 approved), /MHO report/3 rd report : found insane/offence punishable by imprisonment : mental disorder : compulsion order not required : punishment not required : incapacity for relevant matters : personal welfare issues Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Urgent Detention of an Acquitted Person Section : 134 MH (C&T) (S) A 2003 / 60 C CP (S) A 1995 Purpose : for medical assessment re emergency or short term detention Evidence: 2 medical recommendations for mental health disposal : MD / treatability / risk : not convicted : not practicable to secure immediate examination Powers : detention in a place of safety Duration: 6 hours Duties : medical examination Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005

The State Hospital Transfer for Treatment Direction Section Purpose Evidence Conditions : 136 MH (C&T) (S) A 2003 : treatment in hospital of sentenced prisoners : 2 medical reports (1 approved) to Scottish Ministers : MD / treatability / risk / TTD necessary / bed available in 7 days Powers : to transfer and treat in hospital, via a place of safety if necessary. All restricted. Duration : length of prison sentence Duties : RMO (annual report) Revocation or variation : Scottish Ministers or Tribunal : E. D. L. : Parole : Release on life licence Forensic Training L. D. G. Thomson@ed. ac. uk 14 th September 2005